Examination of cranial nerves in head injury

Q) Gaze paresis is seen after head injury? What is responsible for this

a) Facial nerve injury

b) Vestibulo cochlear nerve injury

c) Brain stem dysfunction

d) Optic nerve injury

Answer

Gaze paresis is inability to produce horizontal eye movements in one or both directions. Examination of cranial nerves in head injury is very important to fully assess the extent of injury. Read on for answer

High speed injury

Q14) A young 18 years old unrestrained car driver has an head on collision with a truck and becomes unconscious. He is intubated on the site of accident and resuscitated with IV fluids. He is brought to the emergency in a state of shock,( BP 90/60 and pulse 120/min) but opens eyes on commands. On examination he does not have  pallor but neck veins are distended.

There are no signs suggestive of head or spine injury. Xray chest reveals normal cardiac chambers, no free gas and mild pleural effusion on left with no evidence of fracture ribs.

What will be the next step of management

a) Resuscitation and simultaneous CT thorax

b) Resuscitation and simultaneous Echo cardiography

c) Exploratory laparotomy

d) Chest tube drainage left side

Answer for Premium - Type of injuries in high speed accidents and points to look at